MEDICARE: MR. JAMES VINCE MUELLER MA, CADC-M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1366524555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES VINCE MUELLER MA, CADC-M

Provider Business Mailing Address
First Line	:	231 WASHINGTON BLVD
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49423-3126
Country	:	US
Telephone Number	:	616-396-6872
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 WASHINGTON BLVD
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49423-3126
Country	:	US
Telephone Number	:	616-396-6872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	03/21/2011

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